Department of Pathology

Microbial Pathology

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Mission:
We are interested in the 3- linked arenas of clinical/applied research and their impact upon diagnostic microbiology, specifically, and healthcare, generally: Medical Biofilms, Antibiotic Resistance and Outcomes. For each area we have developed and implemented a model system.

1. BIOFILMS:
CDC states that 80% of nosocomial infections are associated with colonization of indwelling medical devices (IMDs). We have focused on ventilator-associated pneumonia (VAP) in intubated ICU patients and designed, implemented and evaluated a 5-member ventilator/endotrach/mechanical lung model duplicating the ICU patient environment. We wanted to study undisturbed 3-D lumenal biofilms and their architecture under controlled conditions including, pro and eucaryote microbes, substrata, bi-directional mechanical stress factors and physio-chemical environment. Biofilms can be categorized into 4 stages utilizing 6 imaging techniques: radiographic, bright field, CLSM, flow cytometry, SEM and freeze fracture SEM. We presently are using the model to evaluate several anti-biofil designs and strategies.

2. ANTIBIOTIC RESISTANCE:
Here we focus on biofilm “ colonization resistance” utilizing newer, nontraditional microbiology assays and measure the MBEC (ug/mL) (Minimal Biofilm Eradication Concentration) utilizing: 1) flow cytometry, 2) confocal scanning laser micrscopy (CLSM), 3) a modified Calgary Biofilm Device. Considerable effort is evolving to control biofilm diseases of “microbial imbalance” via immunomodulation; we are investigating the new chemically modified tetracyclines (CMTs) as primary mediators of immunomodulation, without development of microbial resistance. Finally, we are using the largest electronic antibiotic resistance database (TSN, Focus Technologies Inc., Herndon, VA) to constantly reevaluate the links of resistance, establishing a “microbial signature” based on unique phenotype and compare these MICs to MBECs..

3. CLIINCAL AND FINANCIAL OUTCOMES:
Quantifiable and measurable patient outcomes are influenced by microbiology procedures. We have designed and implemented strategies that evaluate the benefit of diagnostic/clinical microbiology, particularly recognizing the cost of newer microbial-based technologies (MICROBIOLOGY MANAGEMENT BY OUTCOMES). Is there a measurable clinical and economic benefit? To maximize positive outcomes via early intervention, we are also evaluating computer assisted diagnosis to risk stratify our patients where traditional culture methods are poor predictors. Initially, we have focused on fungal infections using Multi-disease Risk Assessment (MDRA, Pfizer, Inc.), GIDEON (Global Infectious Disease Epidemiology Network) and Rapid Reporting of AST (antimicrobial susceptibility tests) using Vitek (bioMerieux, St. Louis, MO). We presently evaluated the “WVU Bug-Drug CalculatorTM